Hip fracture risk estimation based on bone mineral density of a biomechanically guided region of interest

a preliminary study

Wenjun Li, John Kornak, Caixia Li, Alain Koyama, Isra Saeed, Ying Lu, Thomas Lang

Research output: Chapter in Book/Report/Conference proceedingConference proceeding contribution

Abstract

We aim to define a biomechanically-guided region of interest inside the proximal femur for improving fracture risk prediction based on bone density measurements. The central hypothesis is that by identifying and focusing on the proximal femoral tissues strongly associated with hip fracture risk, we can provide a better densitometric evaluation of fracture risk compared to current evaluations based on anatomically defined regions of interest using DXA or CT. To achieve this, we have constructed a hip statistical atlas of quantitative computed tomography (QCT) images by applying rigid and non-rigid inter-subject image registration to transform hip QCT scans of 15 fractured patients and 15 controls into a common reference space, and performed voxel-by-voxel t-tests between the two groups to identify bone tissues that showed the strongest relevance to hip fracture. Based on identification of this fracture-relevant tissue volume, we have generated a biomechanically-guided region of interest (B-ROI). We have applied BMD measured from this new region of interest to discriminate the fractured patients and controls, and compared it to BMD measured in the total proximal femur. For the femur ROI approach, the BMD values of the fractured patients and the controls had an overlap of 60 mg/cm3, and only 1 out of 15 fractured patients had BMD below the overlap region; for the B-ROI approach, a much narrower BMD overlap region of 28 mg/cm3 was observed, and 11 out of 15 fractured patients had BMDs below the overlap region.
Original languageEnglish
Title of host publicationMedical Imaging 2008
Subtitle of host publicationPhysiology, Function, and Structure from Medical Images: proceedings
EditorsXiaoping P. Hu, Anne V. Clough
Place of PublicationBellingham, Washington
PublisherSPIE
Number of pages8
ISBN (Print)9780819471000
DOIs
Publication statusPublished - 2008
Externally publishedYes
EventMedical Imaging 2008: Physiology, Function, and Structure from Medical Images - San Diego, United States
Duration: 16 Feb 200821 Feb 2008

Publication series

NameProceedings of SPIE
PublisherSPIE
Volume6916
ISSN (Print)1605-7422

Conference

ConferenceMedical Imaging 2008
CountryUnited States
CitySan Diego
Period16/02/0821/02/08

Keywords

  • bone fracture
  • osteoporosis
  • proximal femur
  • quantitative computed tomography
  • image registration
  • atlas
  • bone mineral density

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    Li, W., Kornak, J., Li, C., Koyama, A., Saeed, I., Lu, Y., & Lang, T. (2008). Hip fracture risk estimation based on bone mineral density of a biomechanically guided region of interest: a preliminary study. In X. P. Hu, & A. V. Clough (Eds.), Medical Imaging 2008: Physiology, Function, and Structure from Medical Images: proceedings [691616] (Proceedings of SPIE; Vol. 6916). Bellingham, Washington: SPIE. Progress in Biomedical Optics and Imaging https://doi.org/10.1117/12.769588